122 lines
3.3 KiB
Markdown
122 lines
3.3 KiB
Markdown
---
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type: dmv form
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category: title/registration application
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person: Xuewei Jiang
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date: 2021-07-29
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source: title_application.pdf
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---
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# Application for Title or Registration (REG 343)
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**Form:** REG 343 (REV. 4/2021) WWW
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**Agency:** State of California, Department of Motor Vehicles - A Public Service Agency
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---
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## Section 1 -- Vehicle Information
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| Field | Value |
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|---|---|
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| **Vehicle Identification Number** | 19XFC2F7XGE093564 |
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| **Vehicle Make** | Honda |
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| **Year Model** | 2016 |
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| **Fuel Type** | Gas |
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| **California License Number** | *(blank)* |
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| **Model or Series** | Civic |
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| **Body Type Model** | EX |
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| **Motorcycle Engine Number** | *(blank)* |
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**Type of Vehicle:** [X] Auto (includes truck or pickup)
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**For Trailer Coaches Only:** *(not applicable)*
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- Will this vehicle be used for the transportation of persons for hire, compensation, or profit? **No** [X]
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- Is this a commercial vehicle that operates at 10,001 lbs. or more? **No** [X]
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**For Commercial Vehicles Only:** *(not applicable)*
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---
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## Section 2 -- Owner Information
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| Field | Value |
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|---|---|
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| **True Full Name of Owner** | *(blank)* |
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| **Driver License/ID Card Number** | *(blank)* |
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| **Co-Owner/Lessee** | *(blank)* |
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| **Physical Residence or Business Address** | 11950 Idaho Ave. |
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| **Apt./Space/Ste. No.** | Apt. 113 |
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| **City** | *(blank)* |
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| **State** | CA |
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| **Zip Code** | 90025 |
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| **County of Residence** | Los Angeles |
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| **Equipment Number** | *(blank)* |
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| **Mailing Address** | *(blank)* |
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| **Lessee Address** | *(blank)* |
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---
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## Section 3 -- Legal Owner (Lien Holder/Title Holder)
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**True Full Name of Bank/Finance Company or Individual:** None
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---
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## Section 4 -- Odometer Information
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- [X] As of this date is (if no change in ownership): **28,579** miles
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- Odometer reading reflects the **ACTUAL** mileage
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- No odometer discrepancy noted
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---
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## Section 5 -- Date Information
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| Field | Value |
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|---|---|
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| **Date Vehicle Entered or Will Enter California** | Month: 11, Day: 21, Year: 2020 |
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| **Date Vehicle First Operated in California** | *(blank)* |
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| **Date You Went to Work in CA / Obtained CA DL / Became a Resident** | *(blank)* |
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| **Date Vehicle Was Purchased or Acquired** | Month: 10, Day: 23, Year: 2016 |
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| **Condition** | [X] New |
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| **Purchased** | [X] Outside CA |
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---
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## Section 6 -- Cost Information
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- [X] **PURCHASE** -- I purchased the vehicle for the price of $ *(amount blank)*
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**Vehicle Was Purchased or Acquired From:**
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- [X] Dealer
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**Body type modifications made?** *(not checked -- implied No)*
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---
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## Section 7 -- For Out-of-State or Out-of-Country Vehicles
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- Sales Tax paid to another state? [X] **N/A**
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- Disposition of Out-of-State Plates: [X] **Expired**, or will be or were
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---
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## Section 8 -- Military Service Information
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- Are you or your spouse on active duty as a member of the U.S. Uniformed Services? **No** [X]
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- When this vehicle was last licensed, were you or your spouse on active duty? **No** [X]
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---
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## Section 9 -- Certifications
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*I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.*
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| Field | Value |
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| **Printed Name** | Xuewei Jiang |
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| **Owner's Signature** | X *(signed)* |
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| **Date** | 07/29/2021 |
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| **Daytime Telephone Number** | (254) 214-9350 |
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| **Co-Owner** | *(blank)* |
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